There is an increasing number of older people globally, thus it is essential to build knowledge of how older people view their own ageing, considering their health related circumstances. However, limited attention has been given to attitude towards ageing, particularly in Malaysia. The purpose of this study is to examine the relationship between self-perception of ageing and perceived health status in adults aged 60 years and above. This study is primarily conducted via survey among the elderly patients who are 60 years old and above, who are using the services at public hospitals in Peninsular Malaysia. The ‘Attitudes towards ageing’ questionnaire was used to measure participants’ perception of ageing, while perceived health status was measured using questions from the Study of Global Ageing and Adult Health (SAGE) developed by World Health Organization(WHO). All items in both questionnaires were measured on a 5-point Likert-scale. The findings reveal that positive attitudes to ageing were associated with health status in older adults. The research contributes to greater understanding of the attitudes among the elderly towards ageing and their perceived health status. Understanding these associations may help healthcare providers and policy makers consider strategies to enhance the quality of life of the elderly.
INTRODUCTION Salivary cortisol is used as an indicator of stress level and a recommended screening test for Cushing syndrome. The normal reference interval for salivary cortisol is dependent on the analytical methodology and the population studied and hence, establishment of a local population-based reference interval is recommended. MATERIALS AND METHODS A total of 129 healthy blood donors and staffs of Penang General Hospital were recruited from June 2018-May 2019. Paired (morning and late-night) saliva samples were collected from individuals aged between 18 and 60 years old with no history of chronic medical illness. Salivary cortisol was assayed using electrochemiluminescence immunoassay technique. Non-parametric statistics were used for calculation of reference interval and 90% confidence intervals (90% CIs). RESULTS The reference interval for morning and latenight salivary cortisol was 2.09 - 22.63 nmol/L and <12.00 nmol/L, respectively. CONCLUSION The locally-derived adult reference intervals for morning and late-night salivary cortisol concentration was determined and varied with previous studies emphasising the need in establishing individual laboratory reference interval.
Population ageing is pervasive, a global phenomenon and has implications for society and the nation. Among them is demand for greater allocation of financial resources for healthcare services to cope with this demographic trend. Therefore, this study was aimed at investigating the determinants of utilisation of healthcare services among the elderly in Malaysia. A questionnaire survey was conducted among those aged 60 in 14 public hospitals in Peninsular Malaysia. Findings revealed that age, education level, income level and need for care were associated with healthcare utilisation. Thus, this study contributed to a greater understanding of the determinants of healthcare utilisation among the elderly in Malaysia. Understanding these associations may help healthcare providers and policy makers design strategies to enhance the quality of healthcare services for the elderly.
Haemolytic specimens are a frequent occurrence in clinical laboratories, and they interfere with the analysis of many tests.We describe here an unusual case of leptospirosis complicated by haemolytic anaemia in a 70-year-old man with established kidney failure. He presented with an abrupt onset of shortness of breath, flushing and erythematous rash after completing haemodialysis. The patient's biochemistry test samples were however rejected twice as they were grossly haemolysed. The integrated auto-verification alert system implemented in the hospital's laboratory information system alerted the staff of the possibility of in vivo haemolysis.The auto-verification alert system effectively distinguishes between in vitro and in vivo haemolysis and as such can be utilised as a diagnostic aid in patients with suspected intravascular haemolysis.
There is an increasing number of older people globally, thus it is essential to build knowledge of how older people view their own ageing, considering their health related circumstances. However, limited attention has been given to attitude towards ageing, particularly in Malaysia. The purpose of this study is to examine the relationship between self- perception of ageing and perceived health status in adults aged 60 years and above. This study is primarily conducted via survey among the elderly patients who are 60 years old and above, who are using the services at public hospitals in Peninsular Malaysia. The ‘Attitudes towards ageing’ questionnaire was used to measure participants’ perception of ageing, while perceived health status was measured using questions from the Study of Global Ageing and Adult Health (SAGE) developed by World Health Organization(WHO). All items in both questionnaires were measured on a 5-point Likert-scale. The findings reveal that positive attitudes to ageing were associated with health status in older adults. The research contributes to greater understanding of the attitudes among the elderly towards ageing and their perceived health status. Understanding these associations may help healthcare providers and policy makers consider strategies to enhance the quality of life of the elderly.
Health literacy is a major lever to help individuals assume responsibility for their health. Past studies reported that the problem of health literacy is greatest among the elderly as they utilised more healthcare services and acquire more chronic illness compared to other age group. It is estimated that two-thirds of the elderly are unable to understand the information provided to them regarding the prescribed medication. Research on health literacy has taken place around the world, however research on health literacy among the elderly particularly in Malaysia is relatively small. Therefore, this study was conducted to identify individual factors that influence level of health literacy among the elderly in Malaysia as well as to fill the gap of information in this area. A positivist approach was used to explore the relationship between the variables. The study was primarily conducted via administered survey among 500 elderly outpatients who are 60 years old and above in public hospitals in Malaysia. The level of health literacy was measured using Health Literacy Management Scale (HeLMS), which measure knowledge where to access health and application to manage health. The results of the HeLMS are computed and the findings revealed that the respondents possess a high level of health literacy. The findings further revealed that age group, ethnicity, education and income level were associated with health literacy. As Malaysia is moving towards an ageing nation, the findings of this study will help the healthcare providers and policy makers in establishing provision of continuum care and services for elderly people.
Qualitative Pandy test has long been used to indicate raised globulins in the cerebrospinal fluid (CSF). Despite its shortfalls and the availability of quantitative CSF protein assays, Pandy test continues to be performed in clinical laboratories across Malaysia.(1) Compare diagnostic performance of Pandy test to CSF total protein and albumin; (2) Conduct literature review on clinical utility of Pandy test.This is a retrospective, cross-sectional study involving 890 inpatients of all ages with CSF biochemistry analysed in Hospital Pulau Pinang over a period of 7 months. Patient demographics, clinical diagnosis and CSF total protein, albumin and Pandy results were collected and analysed using Mann-Whitney U test, Spearman rank-order correlation coefficient, Chi Square test and receiver operating characteristic (ROC) curve analysis.CSF total protein, CSF albumin, CSF protein-albumin difference and age showed significantly higher median values in patients with positive Pandy compared to negative Pandy. Significant associations were found between positive Pandy test with clinical diagnosis (Cramers V 0.443, p<0.01), sample haemolysis (Phi 0.326, p<0.01), CSF protein-albumin difference (Spearman 0.727, p<0.001), CSF total protein (Spearman 0.710, p<0.001) and CSF albumin (Spearman 0.662, p<0.01). All three quantified CSF parameters showed comparably good sensitivity and specificity in determining positive Pandy.Good correlation with CSF proteins, analytical issues and reagent hazards indicate no added clinical value of Pandy test in the face of quantified CSF total protein and albumin. Abolishing the test saves resources, reduces occupational hazards and shortens turnaround time without compromising diagnosis.
Physical inactivity is the fourth leading risk factor for global mortality. Regular moderate-intensity physical activity has significant benefits for health. To determine the socioeconomic predictors of physical inactivity among elderly Malaysian population. A nationwide community-based survey was conducted among 4831 respondents aged ≥60 years with a face-to-face questionnaire. The prevalence of physical inactivity among the elderly was 88.0%, highest in respondents aged older than 80 years (95.4%), females (90.1%), other Bumiputra (92.2%), earning household income less than RM1000 (87.9%), and residing in urban locality (88.4%). In the multivariate model, the predictors of physical inactivity were only sex, ethnicity, locality, and age group (adjusted odds ratio = 1.3-3.6). The predictors of physical inactivity can identify the risk factors to develop policies that will reduce the public health burden of noncommunicable diseases.
With increasing number of the older people globally, it is essential to build knowledge of how older people view their own ageing, considering their health related circumstances. However, limited attention has been given to attitudes towards ageing particularly in Malaysia. The purpose of this study is to examine the relationship between self-perception of ageing and perceived health status in adults aged 60 years and above. This study is primarily conducted as a survey design among the elderly patients who are 60 years old and above who are using the services at public hospitals in Peninsular Malaysia. The Attitudes towards ageing questionnaire was used to measure participants’ perception of ageing while perceived health status was measured using questions from Study of Global Ageing and Adult Health (SAGE) developed by World Health Organization (WHO). All items in both questionnaires were measured on a 5-point Likert-scale. The findings reveal that positive attitude to ageing were associated with health status in older adults. The research contributes to greater understanding of the attitudes of the elderly towards ageing and their perceived health status. Understanding these associations may help healthcare providers and policy makers consider strategies to enhance the quality of life of the elderly.
As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.
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